Catheter guiding forceps



y 2, 1967 R. E. SWENSON CATHETER GUIDING FORCEPS Filed Feb. 28, 1964INVENTOR. RUDOLPH E. wam5orq ATTORNEY United States Patent 3,316,913CATHETER GUIDING FORCEPS Rudolph E. Swenson, 40 Acacia Ave., Berkeley,Calif. 94708 Filed Feb. 28, 1964, Ser. No. 348,918 2 Claims. (Cl.128-32l) The invention described herein may be manufactured and used byor for the Government for governmental purposes without the payment tome of any royalty thereon.

This invention relates to a surgical instrument and more particularly toa nongripping catheter guiding forceps for passing a catheter into thetrachea.

In most cases, after topical anaesthesia of the nasal cavity, pharynx,larynx, and tracheobronchial tube, the passage of a catheter into apatients trachea is a routine matter. This pass-age is accomplished bymeans of indirect laryngoscopy. When the anatomy of the pharynx andlarynx is normal, the catheter usually can be passed into the tracheawithout the aid of intubating forceps. If the tip of the catheter isseen in the laryngeal mirror to be just lateral to the aryepiglotticfold, a simple turn of the patients head causes the lateral pharyngealmuscles to push the catheter directly over the glottic chink so that thecatheter may be pushed into the trachea.

Intubation can be quite diflicult, however, if the patient has certainanatomical conformations or abnormalities and especially difficult ifthe patient also tends to gag excessively. In these cases, a forceps hasbeen used to aid intubation. The procedure has been to grasp thecatheter with the forceps and push it into the trachea with a downwardmotion of the forceps. This downward motion of the conventional forcepsusually causes an undesirable spasm of the glottis because of gagging,even though the patient is well anaesthetized.

Accordingly, it is an object of this invention to provide a catheterguiding forceps which will overcome the above disadvantages.

Another object is to provide a catheter guiding forceps which do notgrasp the catheter but rather loosely encircles the catheter to guide itinto the trachea.

Another object of my invention is to provide a catheter guiding forcepsso shaped as to minimize gagging reflex and improve vision and ease ofmanipulation.

Briefly, the invention comprises a scissors-type forceps having asubstantial bend in its shank portion and a slight curve in its bladeportion to facilitate insertion into a patients mouth and throat. Thetip of each blade is preferably curved to form a semicircular jaw. Inthe closed position the jaws of the forceps form a loosely encirclingguide through which the catheter is passed. The jaws do not grip thecatheter.

The structural features of the invention are illustrated in theaccompanying drawings, in which:

FIG. 1 is a perspective View showing the curve of the blades and theangulation of the shanks;

FIG. 2 is a perspective view showing the configuration of the bladetips; and

FIG. 3 is a sagittal view showing the catheter guided by the forcepsinto the trachea by indirect largyngoscopy.

Referring to the drawings, the guiding forceps comprise scissor-typehandles :1 and 2 and levers 3 and 4. The levers are pivotally connectedby pin 5. At the handle portion is an adjustable, releasable latchingdevice for locking the jaws in closed position. This device consists ofoverlapping serrated lateral tabs 6 and 7. The shank portions 8 and 9 oflevers 3 and 4 are bent at a substantial angle to permit better visioninto the patients mouth and to provide for easier manipulation duringthe operation. An included angle of 140 degrees 3,316,913 Patented May2, 1967 between the longitudinal axes of those portions of shanks 8 and9 which include the handle ends and those portions which include thepivot ends: has been found to be satisfactory.

The blade or arm portions 10 and 11 of the forceps are slightly curvedto fit the contour of the back portion of the mouth and to cant theblade tips so as to more easily guide the catheter into the trachea..The inner opposing faces of blades 10 and 11 may be serrated. Thecurvature of the blades and the bend of the shanks are in the samedirection which is downward from a horizontal plane as the forceps isnormally held. An overall length of approximately nine inches has beenfound to be satisfactory for manipulation, with the distance between theblade tips and the shank bend being approximately five and one-halfinches.

The tips 12 and 13 of the blades are smooth surfaced and are each bentwithin the longitudinal plane of the blades, preferably into the shapeof a semicircle. When the forceps blades are closed, the tips preferablyform a circular aperture through which the catheter is passed. Thedistal ends of the blade tips do not touch in the closed position.

In operation, the catheter 14 is .inserted through the nasal cavity intothe mid-pharnyx region. The catheter is then gently encircled with thetips of the guiding forceps. With the help of a laryngeal mirror 15, thetip of the catheter is then guided just superior to the glottic chinkand an attendant is signalled to push the catheter along the floor ofthe nose until it has been observed to enter the trachea. The encirclingtip of the forceps does not grasp the catheter but merely guides it. Consequently, no downward motion of the forceps is re quired to pass thecatheter into the trachea, and thus the gag reflex is minimal. The shankdesign allows the operator to see into the mouth and at the same timemore easily manipulate the forceps, and the curve of the blades helps toreduce the gagging reflex and more easily align the catheter with thetrachea opening.

I claim:

.1. An intubating forceps for use with a catheter dimensioned for entrythrough the nasal cavity into the trachea for indirect laryngoscopycomprising, a pair of levers pivotally connected to provide forwardreaching arms and rearwardly extending handles, said arms terminated insemi-circular formed tips movable with said arms to closed and openpositions and in close-d position providing a circular opening having aninternal dimension to loosely encircle at least a majority of theperiphery of said catheter, said tips in open position separating to adimension clearing said catheter periphery for removal therefrom, saidhandles directly diverging rearwardly from said pivot with the endsbeing formed into finger engaging rings for operating the forceps, saiddivergence being on an acute angle to a straight line taken from thepivot rearwardly to a point between the rings, said handles having adownwardly extending obtuse angle therein intermediate the pivot and therings, said handles extending rearwardly from the pivot to the obtuseangle in a common horizontal plane and from the obtuse angle to therings in another common horizontal plane and at the obtuse angle to thefirst horizontal plane, said arms extending forwardly from the pivot inengagement with each other in closed position to the point of thesemicircular tips and having a downwardly extending curve intermediatethe pivot and tips, said arms extending from the pivot to the point ofcurvature in a common horizontal plane and in alinement with the firsthorizontal plane of the handles and from the point of curvature to thetips in another common horizontal plane, said tips and arms being soformed and dimensioned to position said opening in a plane substantiallyperpendicular to e longitudinal axis of the midpharnyx passageway and.bstantially coaxially thereto with said handles extendg exteriorly ofthe mouth for movement of said tips open and closed positions withoutobstruction to view F the operating area of the rear of the mouth and.roat, said tips and adjacent arms being formed and mensioned forinsertion through the mouth and into .e midpharnyx passageway and foropening and closing 5 said tips therein to encircle the leading endportion 5 said catheter for guided axial reciprocation and lateral)sitioning into alinement with the trachea.

2. The method of inserting into the trachea a catheter .mensioned forentry through the nasal cavity for in- .rect laryngoscopy comprising,passing said catheter trough the nasal cavity and into the midpharnyxpaslgeway, positioning in the mouth intubating forceps avingcomplementarily formed tips moveable to closed 1d open positions and inclosed position providing an pening having an internal dimension toloosely encircle least a majority of the periphery of said catheter andI open position being formed to separate to a dimenon clearing saidcatheter periphery for encircling and :moval therefrom, locating saidtips in said midpharnyx assageway with the plane of said openingsubstantially 10 References Cited by the Examiner UNITED STATES PATENTS3,063,455 I l/1962 Markley 128-32 1 15 FOREIGN PATENTS 138,700 10/1960Russia.

OTHER REFERENCES The Lancet, page 687, column 2 relied on, SeptemberRICHARD A. GA'UDET, Primary Examiner.

G. MCNEI'LL, Assistant Examiner.

1. AN INTUBATING FORCEPS FOR USE WITH A CATHETER DIMENSIONED FOR ENTRYTHROUGH THE NASAL CAVITY INTO THE TRACHEA FOR INDIRECT LARYNGOSCOPYCOMPRISING, A PAIR OF LEVERS PIVOTALLY CONNECTED TO PROVIDE FORWARDREACHING ARMS AND REARWARDLY EXTENDING HANDLES, SAID ARMS TERMINATED INSEMI-CIRCULAR FORMED TIPS MOVABLE WITH SAID ARMS TO CLOSED AND OPENPOSITIONS AND IN CLOSED POSITION PROVIDING A CIRCULAR OPENING HAVING ANINTERNAL DIMENSION TO LOOSELY ENCIRCLE AT LEAST A MAJORITY OF THEPERIPHERY OF SAID CATHETER, SAID TIPS IN OPEN POSITION FOR REMOVALDIMENSION CLEARING SAID CATHETER PERIPHERY FOR REMOVAL THEREFROM, SAIDHANDLES DIRECTLY DIVERGING REARWARDLY FROM SAID PIVOT WITH THE ENDSBEING FORMED INTO FINGER ENGAGING RINGS FOR OPERATING THE FORCEPS, SAIDDIVERGENCE BEING ON AN ACUTE ANGLE TO A STRAIGHT LIEN TAKEN FROM THEPIVOT REARWARDLY TO A POINT BETWEEN THE RINGS, SAID HANDLES HAVING ADOWNWARDLY EXTENDING OBTUSE ANGLE THEREIN INTERMEDIATE THE PIVOT AND THERINGS, SAID HANDLES EXTENDING REARWARDLY FROM THE PIVOT TO THE OBTUSEANGLE IN A COMMON HORIZONTAL PLANE AND FROM THE OBTUSE ANGLE TO THERINGS IN ANOTHER COMMON HORIZONTAL PLANE AND AT THE OBTUSE ANGLE TO THEFIRST HORIZONTAL PLANE, SAID ARMS EXTENDING FORWARDLY FROM THE PIVOT INENGAGEMENT WITH